Key result
Omapatrilat reduced systolic blood pressure 3.6 mm Hg more than enalapril and required less adjunctive therapy (19% vs 27%, P<0.001), but increased angioedema risk (2.17% vs 0.68%).
Why the study?
Does omapatrilat improve blood pressure reduction compared to enalapril in patients with untreated or uncontrolled hypertension?
RCT (n=25,302)
Double-blind
randomized
Yes
Does omapatrilat improve blood pressure reduction compared to enalapril in patients with untreated or uncontrolled hypertension?
Absolute Event Rate: 19% vs 27%
p-value: p=<0.001
Omapatrilat provides superior blood pressure reduction compared to enalapril but is associated with a higher risk of angioedema.
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Angioedema risk outweighs BP benefit for routine use; extends safety data on dual NEP/ACE inhibition.
William J. Kostis (2004) conducted an RCT in untreated or uncontrolled hypertension (n=25,302). Omapatrilat vs. Enalapril 5 mg initial, titrated up to 40 mg once daily was evaluated on Use of adjunctive antihypertensive therapy by week 24 (p=<0.001). Omapatrilat reduced systolic blood pressure 3.6 mm Hg more than enalapril and required less adjunctive therapy (19% vs 27%, P<0.001), but increased angioedema risk (2.17% vs 0.68%).
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